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DETERMINANTS OF HEALTH INEQUALITIES

A range of NCEPH research activities are connected by their underlying interest in the processes that foster or diminish health inequalities.

1. Socio-cultural determinants of ‘dangerous consumption'
Socio-economic gradients in health outcomes have been extensively documented, with an emphasis on the socio-material conditions of environments and individuals. More recently, public health attention has turned to the socio-cultural processes associated with consumption practices and their health risks. 

Researchers at NCEPH are studying patterns of consumption involved in car reliance, sedentariness, eating energy-dense foods, use of alcohol and other drugs, convenient solutions to time pressures, and fashions in parenting. At present, this work focuses mainly on Australia and Thailand .

Our recent book The Seven Deadly Sins of Obesity: How the Modern World is Making Us Fat contains innovative contributions from many members of the Centre. Other examples of recent publications by NCEPH include research on dangerous consumption among building workers http://www.informaworld.com/smpp/content~content=a747655406~db=all~order=page) and

Hinde S , Dixon, J . Changing the ‘obesogenic environment': insights from a cultural economy of car-reliance, Transportation Research Part D - Transport and the Environment, 2005; 10: 31-53.

A major ongoing project involves interviews with family members from three generations whose lives have spanned the recent rapid rise in population obesity. We are also undertaking a cultural economy investigation of the major social trends identified by Australian experts as underlying changes in diet and physical activity over the last half century.

2. Healthy urban and rural spaces and places
NCEPH has begun a long-term collaboration with CSIRO Sustainable Ecosystems to develop and apply decision-support tools for urban planning. Tools currently under development include a ‘Timekit' containing case studies of policies that consider time demands on citizens in the implementation of health or environmental interventions. (See Strazdins L, Loughrey B. Too busy: why time is a health and environmental problem. NSW Public Health Bulletin, 2007; 18 , 219-221.)

Another tool will address ways of capturing ‘conviviality' or social connectedness. We are also studying the obesogenic and mental-health impacts of climate change in rural areas.

3. Ecological nutrition and food supply chains
Several research activities at NCEPH focus on various aspects of food and nutrition systems. We are studying: the global and national nutrition transitions, food systems and the environment, restructuring the food system (with special attention to supermarkets), and inequity in urban food systems.

4. Work, family life and health
Research in this area pushes the boundaries of traditional occupational health and safety to investigate the ways the working conditions affect the health not only of employees but also their families. Mostly based on survey research, researchers have a particular focus on developing a more practical and wide-ranging understanding of ‘family friendliness' as a basis for improved organisational and government policies. Recent articles by Lyndall Strazdins and others exemplify this innovative research.

NCEPH has sponsored and organised two national symposia involving a range of academic, industry, union and policy stakeholders to discuss these matters. The Centre collaborated with Families Australia to host the first National Family Wellbeing Symposium in June 2007. The focus was on the meaning and measurement of family wellbeing, to develop a framework for policy and research.

5. Social theories of health
Despite the international visibility of social determinants of health research, there has been comparatively little development of theories to explain observed patterns. Our interests focus on three theoretical problems and perspectives: social contagion as a contributor to health differentials; the intergenerational transmission of health inequalities; and the ways gender and class interrelate in shaping health.

6. Improving Indigenous health
Closing the 17 year gap in life expectancy between Indigenous and non-Indigenous people, and measures to control alcohol use are both at the forefront of current Australian health campaigns. Staff from Winnunga Nimmityjah Aboriginal Health Service (in the ACT) and NCEPH are working on a project “ Where's your country?” “Who're your people?” Asking the right questions when treating problematic alcohol use amongst Indigenous Australians . The project aims to improve services for urban-based Indigenous peoples who are experiencing problematic alcohol use.

Theme contact: Dorothy Broom